Endoscopic Sinus Surgery Recovery Guide

What should I expect?

Endoscopic sinus surgery takes about 1 to 3 hours, and most people go home the same day. We do not pack the nose with gauze after sinus surgery. All of these are normal in the first week or two:

• Some bleeding from the nose for the first few days, and pink or blood-tinged drainage for several days after that.
• Nasal pain, facial pressure and congestion. Pain is usually mild and is worst in the first 2 to 3 days. You may feel more congested than you did before surgery, because of swelling and crusting inside the nose.
• Feeling tired, and a weaker sense of smell.

These improve steadily as the sinuses heal. The full benefit of surgery, such as easier breathing and a better sense of smell, usually develops over 4 to 6 weeks.

Had septoplasty too?

Many people have septoplasty, often with turbinate reduction, at the same time as sinus surgery. Recovery is very similar, and everything in this guide still applies, with a few additions:

• Rinsing: rinse with saline as described below.
• Splints: if splints were placed inside your nose, they come out 3 to 7 days after surgery.
• Numb teeth: your upper front teeth or gums may feel numb. This almost always goes away, usually within a few weeks.
• Turbinate reduction: crusting, dryness and stuffiness can last longer, up to about 6 weeks, while the turbinates heal. Rinsing helps clear the crusts.
• Protect your nose: your nose stays fragile for at least 6 weeks, so avoid anything that could bump it, and wait for your surgeon’s OK before contact sports.

Our Septoplasty Recovery Guide has more on healing after septoplasty and when breathing improves.

How do I rinse after surgery?

Saline rinses are the most important part of healing. They wash out old blood, mucus and crusts and keep the lining moist. The more you rinse, the less crusting needs to be removed at your post-op visit, and the better you heal.

• Start the day after surgery, unless your surgeon tells you otherwise.
• Rinse at least 4 times a day until your first post-op visit. After that, keep rinsing as your surgeon directs; many people rinse for several weeks while the lining heals.
• Use a large-volume squeeze bottle, such as a NeilMed Sinus Rinse kit from any drug store, with the saline packets that come with it. A rinse reaches the sinuses far better than a spray. Our guide How to Do a Nasal Saline Rinse shows each step.
• Use the full bottle each time, about 8 ounces (240 mL), half in each nostril.
• Use room-temperature distilled water. Tap water is not sterile, and the CDC advises against using it to rinse the nose. Sterile water, or tap water that was boiled and then cooled, is also safe.
• Let the rinse drain out on its own. Do not blow your nose for 1 week after surgery. Pink rinse water and some crusts in the first weeks are normal.
• Clean the bottle after each use with warm water and a little dish soap, rinse it well and let it air-dry. Replace it every 3 months, or sooner if it cracks or discolors.

Your surgeon will tell you whether and when to use a steroid spray, or a steroid added to your rinse.

What about bleeding?

Some bleeding from the nose is expected for the first few days, and a little oozing after rinsing or activity is normal.

• Tape a piece of gauze under your nose if there is mild bleeding, and change it as needed.
• You may use Afrin nasal spray as needed for bleeding and congestion for 3 to 5 days after surgery. Stop after 3 to 5 days, because longer use causes rebound stuffiness.
• If it bleeds, sit up and lean slightly forward (do not tip your head back), use a spray or two of Afrin, then pinch the soft lower part of the nose firmly for 15 minutes without letting go.
• Call us for bleeding that does not stop, or any bleeding that worries you. Call 911 or go to the ER for severe bleeding you cannot control, or bleeding with lightheadedness or fainting.

How should I manage pain?

Pain after sinus surgery can usually be controlled with over-the-counter medicine, and most people need little or no prescription pain medicine.

• Acetaminophen (Tylenol): 1,000 mg every 6 hours, no more than 4,000 mg in 24 hours (or 3,000 mg if your package says so, or if you have liver problems or drink alcohol regularly).
• Ibuprofen (Advil, Motrin): 400 mg every 8 hours with food, or naproxen (Aleve): 1 tablet (220 mg) every 8 to 12 hours with food, no more than 3 tablets in 24 hours. These are fine to take after sinus surgery. Skip them if you have a stomach ulcer or kidney disease, or if your surgeon told you not to take them.
• You can alternate acetaminophen with ibuprofen or naproxen for better relief, keeping to each one’s dose limits.
• If we prescribed medicine, such as a pain medicine, a steroid or an antibiotic, take it exactly as directed. Most people do not need an antibiotic after sinus surgery.
• If you take aspirin or a blood thinner, follow your surgeon’s instructions on when to restart it.

What else helps?

• Sleep with your head raised for the first 3 nights: raise your head and shoulders about 30 to 45 degrees, using a foam wedge, 2 or 3 pillows under your upper back and head, or a recliner. Keep doing it longer if it helps you breathe.
• A cold pack over the nose and cheeks eases swelling. Wrap a cold pack or a bag of frozen peas in a thin towel and hold it on for 15 to 20 minutes, then off for at least 20 minutes. Repeat as often as you like while awake for the first 48 hours. Rest it lightly; do not press on the nose.
• Walking is fine and encouraged, starting right away.
• If you use CPAP, keep using it while you heal, starting the night of surgery.
• Do not smoke or vape until your surgeon confirms you have healed. Smoking slows healing and raises the chance of infection; quitting for good helps most.

When can I get back to normal?

• After anesthesia: for 24 hours, do not drive, drink alcohol, use machinery or sign important papers. After general anesthesia, we recommend having an adult stay with you the first night.
• No heavy lifting, straining, bending over, strenuous exercise or anything tiring for 1 week. After that, ease back into your normal activities.
• Do not blow your nose for 1 week. If you sneeze, sneeze with your mouth open.
• Some people go back to work in a couple of days, and some take up to a week.
• For at least 1 week, stay within about an hour’s drive of our office or a hospital emergency room. Do not fly for 2 weeks.
• Do not swim until your surgeon says it is OK.

What these limits mean: heavy lifting means anything over about 10 pounds (a gallon of milk weighs about 8), such as a full laundry basket, a case of water or a suitcase. Strenuous activity means anything that makes you breathe hard, strain or sweat: running, weight training, yard work, hard cycling or sports. Walking, light housework, desk work and showering are fine. When the limit ends, start at about half your usual effort and build up over a week; if bleeding starts, stop and rest.

What happens at my first visit?

• Your sinuses are cleaned. At your first post-op visit, usually about a week after surgery, your surgeon uses numbing medicine, small instruments and gentle suction to remove crusts and clots so the sinuses heal open. It can be uncomfortable but is quick. Scar tissue is the most common problem after sinus surgery, and this cleaning (debridement) helps prevent it.
• Keep every cleaning appointment, even if you feel well. Some people need more than one.
• Check your coverage. Each insurance plan covers the cleaning differently. Some apply a deductible or do not cover it, so there may be an extra charge. If you have questions, ask your insurer about CPT code 31237.

Watch: what to expect after FESS

FESS: What to Expect & Recovery Tips

A short video from our team on endoscopic sinus surgery and the first days of recovery.

Watch on YouTube

When should I call?